Recent developments underscore the potential of textual information in enhancing learning models for a deeper understanding of medical visual semantics. However, language-guided medical image segmentation still faces a challenging issue. Previous works employ implicit and ambiguous architectures to embed textual information. This leads to segmentation results that are inconsistent with the semantics represented by the language, sometimes even diverging significantly. To this end, we propose a novel cross-modal conditioned Reconstruction for Language-guided Medical Image Segmentation (RecLMIS) to explicitly capture cross-modal interactions, which assumes that well-aligned medical visual features and medical notes can effectively reconstruct each other. We introduce conditioned interaction to adaptively predict patches and words of interest. Subsequently, they are utilized as conditioning factors for mutual reconstruction to align with regions described in the medical notes. Extensive experiments demonstrate the superiority of our RecLMIS, surpassing LViT by 3.74% mIoU on the publicly available MosMedData+ dataset and achieving an average increase of 1.89% mIoU for cross-domain tests on our QATA-CoV19 dataset. Simultaneously, we achieve a relative reduction of 20.2% in parameter count and a 55.5% decrease in computational load. The code will be available at https://github.com/ShashankHuang/RecLMIS.
Medical image segmentation models adapting to new tasks in a training-free manner through in-context learning is an exciting advancement. Universal segmentation models aim to generalize across the diverse modality of medical images, yet their effectiveness often diminishes when applied to out-of-distribution (OOD) data modalities and tasks, requiring intricate fine-tuning of model for optimal performance. For addressing this challenge, we introduce SegICL, a novel approach leveraging In-Context Learning (ICL) for image segmentation. Unlike existing methods, SegICL has the capability to employ text-guided segmentation and conduct in-context learning with a small set of image-mask pairs, eliminating the need for training the model from scratch or fine-tuning for OOD tasks (including OOD modality and dataset). Extensive experimental validation of SegICL demonstrates a positive correlation between the number of prompt samples and segmentation performance on OOD modalities and tasks. This indicates that SegICL effectively address new segmentation tasks based on contextual information. Additionally, SegICL also exhibits comparable segmentation performance to mainstream models on OOD and in-distribution tasks. Our code will be released soon.